week 2: differential dx Flashcards by Lauren Bainter

which systems have an inconsistent symptom pattern?

psychologic
endocrine
neurologic
rheumatic disorders
adverse drug reactions

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what does a pain description of throbbing, pounding, and pulsating indicate?

vascular disorders
(ex: AAA, PVD)

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what does a pain description of sharp, lancinating, shocking, and burning indicate?

neurological disorders

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what does a pain description of aching, squeezing, gnawing, burning, and cramping indicate?

visceral disorders

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suspected diff dx:
constant back pain not affected by mvmt
back pain worse at night
unexplained weight loss
failure of conservative treatment

back-related tumor

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suspected diff dx:
spine rigidity
deep constant pain, increased with WB
fever, malaise, swelling

back-related infection (ex: spinal osteomyelitis)

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suspected diff dx:
hx spinal stenosis
hx of DDD
urinary retention or incontinence
saddle anesthesia
global or progressive weakness in LEs

cauda equina syndrome

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suspected diff dx:
exquisitely tender w/ palpation over site
local edema
increased back pain with WB
hx of trauma
long-term steroid use
over 70 yo

spinal fx

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suspected diff dx:
back, abdominal, or groin pain
PVD or CAD
symptoms not related to mvmt
bruit in epigastric area

abdominal aneurysm

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suspected diff dx:
pain unchanged by position or mvmt
age >50
unexplained weight loss
bowel disturbances

colon cancer

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what are the most common places for metastasis of colon cancer?

liver, lung, bone, brain

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suspected diff dx:
older female >70
hip, groin, or thigh pain
hx of fall from standing
severe, constant pain
shortened and ER’d LE

pathological fx in femoral neck

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which pelvis region disease is for younger kids? older?

younger: Legg-Calve-Perthes disease
older: SCFE

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suspected diff dx:
stiff hip joint
hx of long-term corticosteroid use
trauma
gradual onset of hip pain that worsens with WB

osteonecrosis of femoral head

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suspected diff dx:
5-8 yo boy
groin/thigh pain
antalgic gait
pain with hip abd & IR

Legg-Calve-Perthes disease

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suspected diff dx:
overweight adolescent (esp male)
recent growth spurt or trauma
aching in groin worse with WB
leg in ER
ROM limited in IR

SCFE

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suspected diff dx:
>60
hx of T2DM &/or ischemic heart disease
sedentary, smoker
intermittent claudication
cool extremity

peripheral arterial occlusive disease

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DVT has ____ symptoms, while compartment syndrome has ____ symptoms (intermediate/constant)

DVT: intermittent
compartment syndrome: constant

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suspected diff dx:
recent surgery, malignancy, pregnancy, trauma, or leg immobilization
calf pain, edema, tenderness, warmth
pallor, loss of dorsalis pedis pulse

DVT

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suspected diff dx:
blunt trauma, crush injury
severe, persistent leg pain
swelling, severe leg pain

compartment syndrome

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suspected diff dx:
hx of recent infection, surgery, or injection
immunosuppressant disorder
constant aching or throbbing in joint
elevated body temperature

septic arthritis

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suspected diff dx:
hx of recent skin ulceration or abrasion
hx of venous insufficiency, CHF, cirrhosis
pain, skin swelling, warmth
advancing irregular margin of erythema/reddish streak

cellulitis

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suspected diff dx:
men >40, women >50 yo
chest pain, palpitations
pallor, sweating, dyspnea, nausea
hx of CAD, HTN, smoking, DM, elevated cholesterol

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myocardial infarction

suspected diff dx:
hx of CAD
chest pain outside of predictable pattern
unresponsive to nitroglycerin

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unstable angina pectoris

suspected diff dx: >65 yo hx of CAD chest pain that occurs with predictable level of exertion sx alleviated with nitroglycerin

stable angina pectoris

suspected diff dx: autoimmune disease sharp, stabbing chest pain increased chest pain with side lying chest pain relived with forward sitting

pericarditis

suspected diff dx: immobility, trauma, &/or cancer chest, shoulder, upper abdominal pain dyspnea, tachycardia, tachypnea

suspected diff dx: hx of recurrent respiratory disorder severe, sharp pain with inspiration dyspnea, decreased chest wall excursion

pleurisy

suspected diff dx: recent bout of coughing or strenuous ex pleuritic pain fever, chills, HA, malaise, nausea

pneumothorax

suspected diff dx: hx of infection pleuritic pain fever, chills, malaise, HA, nausea

pneumonia

suspected diff dx: sx worsen with ingestion of fatty foods middle aged woman colicky pain in R upper quadrant R scapular pain

cholecystitis

suspected diff dx: sx relieved with ingestion of food pain in epigastrium, midback, or supraclavicular regions tenderness at R epigastrium tarry stool

peptic ulcer

suspected diff dx: recent or current UTI &/or kidney stone enlarged prostate tenderness over costovertebral angle

pyelonephritis

where are the most common levels of spinal fx?

T11-L1

suspected diff dx: sudden severe back or flank pain renal colic symptoms of UTI fever, malaise, nausea, vomiting

nephrolithiasis (kidney stone)

suspected diff dx: hx of fall, MVA, osteoporosis long-term steroid use age >70 midline tenderness LE neuro signs increased thoracic kyphosis

spinal fx

suspected diff dx: hx of infection, skull fracture + slump sign HA, fever, nausea, vomiting photophobia, confusion seizures, sleepiness

meningitis

suspected diff dx: age 24-64 yo HA, altered mental status ataxia, speech deficits sensory abnormalities visual changes, seizures

primary brain tumor

suspected diff dx: hx of smoking, HTN, alcohol abuse sudden onset HA bries LOC brain tumor signs meningeal irritation signs

subarachnoid hemorrhage

suspected diff dx: major trauma hx RA or AS oral contraceptive use + Babinski sign dizziness, nystagmus, vertigo, clonus

cervical ligamentous instability with possible cord compromise

suspected diff dx: paresthesias retrograde distribution of pain UE muscle tender to palpation

cervical & shoulder girdle entrapment neuropathies

suspected diff dx: men >50 w/ smoking hx nagging pain in shoulder & scapula nagging pain --> burning in ulnar n. distr.

Pancoast's tumor (superior sulcus long tumor)

suspected diff dx: asymmetry of neck line inability to shrug shoulder lack scapular stabilizers weak shoulder abduction

spinal accessory nerve disorder

suspected diff dx: >40 with shoulder dislocation weak shoulder abduction & flexion lack sensation in lateral aspect of up arm

axillary nerve disorder

suspected diff dx: serratus anterior weakness loss of scapulohumeral rhythm

long thoracic nerve disorder

suspected diff dx: deep, poorly localized pain weak shoulder abduction and ER hx of scapula fracture

suprascapular nerve disorder

suspected diff dx: FOOSH with forearm supinated elbow held at side

radial head fx

suspected diff dx: FOOSH w/ forceful wrist extension >40

distal radius fx (Colles') (most common)

suspected diff dx: pain in anatomical snuff box

scaphoid fx

suspected diff dx: FOOSH diffuse synovitis

lunate fx or dislocation

suspected diff dx: FOOSH w/ forearm pronated ulnar-sided wrist pain

TFCC tear

suspected diff dx: recent skin puncture, insect bite presence of abcess purulent tenosynovitis signs of o=inflammation

space infection of hand

suspected diff dx: hx RA, trauma, corticosteroid use hand/wrist tenderness, swelling, muscle spasms, hematoma

long flexor tendon rupture

suspected diff dx: hx RA, smoking, beta blocker use hands or feet blanch & turn red when exposed to cold or emotional stress

Raynaud's disease

suspected diff dx: hypersensitivity pain doesn't respond to analgesics swelling (pitting edema), warm aching, stinging, cutting, burning pain pain not typical to injury

complex regional pain syndrome

week 2: differential dx Flashcards

(55 cards)